P33 A population-based study describing the burden of disease in patients with vitiligo and on the healthcare system in the UK
Authors: Viktoria Eleftheriadou, Carine Delattre, Iftekhar Khan, Amit Mathew, Shala Chetty-Mhlanga, Christopher Lee, Clare Flach, Andrew R Thompson
Journal: British Journal of Dermatology (2023)

Abstract The prevalence of vitiligo is estimated to be between 0.5% and 2.0% globally, with marked geographical differences. Patients with vitiligo may be burdened by comorbidities and a lack of satisfactory treatment. UK evidence on the vitiligo-associated burden of disease and healthcare resource utilization is lacking. Patients aged ≥ 12 years with vitiligo were identified using data from UK administrative healthcare databases (Clinical Practice Research Datalink; Hospital Episode Statistics database). The incidence of vitiligo and point prevalence on 1 January was calculated annually between 2010 and 2021. The rate of dermatology-related primary and secondary care events and the percentage of patients receiving vitiligo-related treatments were calculated for the 5 years after diagnosis. Time to treatment following diagnosis was analysed using Kaplan–Meier curves. Of 17 239 patients with vitiligo, the overall mean incidence was 0.164 (range 0.096–0.188) per 1000 person-years between 2010 and 2021; prevalence was 0.30% (range 0.21–0.38%). Comorbidities (recorded after vitiligo) included diabetes (19.4%), eczema (8.9%), thyroid disease (7.5%) and rheumatoid arthritis (6.9%); mental health comorbidities (recorded before or after vitiligo) included anxiety/depression (24.6%), depression (18.5%) and anxiety (16.0%). General practitioner consultations per 1000 person-years reduced from 979 in the first year after diagnosis to ≤ 65 in years 2–5 after diagnosis. Outpatient dermatology-related hospital events per 1000 person-years decreased from 1019 in the first year to 569 in the third year and then appeared to remain stable. In the first year after diagnosis, 61% of patients did not receive any vitiligo-related treatment (e.g. topical steroids, topical calcineurin inhibitors, oral steroids and phototherapy), increasing to 82% from the second year onwards; 85% of prevalent patients (2019) did not receive any vitiligo-related treatment. The median time from diagnosis to first treatment (incident cohort) was 34 months. The prevalence of vitiligo (0.3%) reported here is comparable to recent UK estimates (0.3%) representing patients seeking medical care. The incidence of vitiligo remained stable between 2010 and 2019, reducing from 2020 following the onset of the COVID-19 pandemic. Diabetes, rheumatoid arthritis, thyroid disorders and mental health comorbidities (consistent with reports from others) indicate a burden in seeking care for comorbidities in addition to the health needs of vitiligo. The majority of patients not on vitiligo-related treatment within a year of diagnosis, and the length of time to first treatment, suggest a gap in effective therapeutic options and early treatment for vitiligo. New effective treatment options, early treatment initiation and psychological intervention are needed to reduce the burden of vitiligo. Funding sources: Incyte Corporation.